Howard v. Motorists Mutual Insurance

955 S.W.2d 525, 1997 Ky. LEXIS 73, 1997 WL 336304
CourtKentucky Supreme Court
DecidedJune 19, 1997
Docket95-SC-944-DG
StatusPublished
Cited by15 cases

This text of 955 S.W.2d 525 (Howard v. Motorists Mutual Insurance) is published on Counsel Stack Legal Research, covering Kentucky Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Howard v. Motorists Mutual Insurance, 955 S.W.2d 525, 1997 Ky. LEXIS 73, 1997 WL 336304 (Ky. 1997).

Opinions

[526]*526STUMBO, Justice.

Appellant, Corliss Howard, challenges a decision of the Court of Appeals reversing a Shelby Circuit Court judgment compelling Appellee, Motorists Mutual Insurance Company (“Motorists”), to provide insurance coverage for a 1991 auto accident. This opinion addresses whether estoppel or waiver can, under certain circumstances, preclude an insurance company from denying coverage after it has cashed an insured’s cheek and retained the funds.

On April 29,1989, Appellant contacted Ap-pellee, Doetrow-Rieh Insurance Agency (“Doetrow”), an independent insurance agency, to obtain automobile liability insurance. After an initial rejection, Motorists issued Appellant an insurance policy. Over the next year-and-a-half, Motorists continued to insure Appellant, even though she often sent in late payments and, in two instances, actually let her insurance lapse.

On December 17, 1990, Motorists sent Appellant a renewal billing statement indicating it would renew her auto insurance policy until July 19, 1991, if it received a renewal payment by January 18,1991. Appellant did not forward a payment by the expiration date and, on January 29, 1991, Motorists sent Appellant a letter advising her to contact her agent to “discuss her insurance needs.” Appellant did so, stopping by Doctrow’s office on February 3. Doetrow did not accept Appellant’s tendered payment on Motorists’ behalf, as he had sometimes done in the past. Instead, the agent told her to forward the payment directly to Motorists. Appellant mailed a check for $126.94 to Motorists on February 5. Upon receipt on February 7, Motorists cashed the.check, deposited Appellant’s premium payment and issued her a receipt with policy number.

On February 19, 1991, pursuant to an internal policy regarding frequent policy lapses, an underwriter at Motorists sent a letter, along with a refund of Appellant’s premium payment, to Doetrow. Doetrow received the. notice and check on February 22 and forwarded it to Appellant that same day. Unfortunately, Appellant had an auto accident on February 22. The driver and passenger in the other vehicle, Appellees George Terry and Timothy Waxier, sued Appellant. Motorists refused to extend coverage or defend Appellant in the action. As a result, Appellant filed a third-party complaint against both Motorists and Doetrow.

The Shelby Circuit Court entered summary judgment in favor of Appellant on the coverage issue, requiring Motorists to defend Appellant and provide coverage for any losses. Since Motorists had a duty to cover the loss, the trial court dismissed Appellant’s action against Doetrow, the independent agent, as moot. Motorists appealed, and Appellant filed a cross-appeal regarding the dismissal of her action against Doetrow. The Court of Appeals reversed, rejecting Appellant’s estoppel argument and holding that the cashing of Appellant’s check did not create a contract of insurance. We granted Appellant’s request for discretionary review and now reverse.

Citing past dealings between the two, Appellant contends that, by cashing her check and issuing her a receipt, the insurance company has either waived its right to deny coverage or is estopped from doing so. In response, Motorists contends that Appellant’s policy had lapsed, and that under Troutman v. Nationwide Mut. Ins. Co., Ky., 400 S.W.2d 215 (1966), the mere cashing of a premium check does not create a contract of insurance. After considering the arguments of both parties, under the peculiar facts of this case, we must agree with Appellant.

Because Appellant asserts a mixed bag of arguments implicating both waiver and estoppel, the Case of Edmondson v. Pennsylvania Nat’l Mut. Casualty Ins. Co., Ky., 781 S.W.2d 753 (1989), is instructive. “Waiver and estoppel, as applied to contracts of insurance, are terms often used interchangeably, but this obscures their meaning.” Id. at 755. The two are separate and distinct concepts. Waiver, we have said, is “bottomed on a voluntary and intentional relinquishment of a known, existing right or power under the terms of an insurance contract.” Id. (quoting Long, The Law of Liability Insurance § 17.14).. After an internal review, Motorists refunded Appellant’s premium. While Motorists’ untimely refund of [527]*527Appellant’s premium might be attributable to flawed procedures, we cannot characterize it as the kind of intentional act that establishes a waiver. Motorists did not intend to waive its right to refuse to renew Appellant’s coverage, nor its right not to issue her a new policy. Instead, it is not unfair to say that Motorists simply failed to act. Thus, as defined by Edmondson, the doctrine of waiver does not apply here. If Appellant is to prevail, she must do so using estoppel.

According to Edmondson, estoppel “offsets misleading conduct, acts, or representations which have induced a person to rely thereon to change his position to his detriment.” Id. (quoting Long, The Law of Liability Insurance § 17.14). Gray v. Jackson Purchase Credit Ass’n, Ky.App., 691 S.W.2d 904 (1985), sets forth the elements of estoppel:

(1) Conduct, including acts, language and silence, amounting to a representation or concealment of material facts; (2) the es-topped party is aware of these facts; (3) these facts are unknown to the other party; (4) the estopped party must act with the intention or expectation his conduct will be acted upon; and (5) the other party in fact relied upon this conduct to his detriment.

Id. at 906. Applying this test to the case at bar, we hold that Motorists is estopped from denying coverage.

We first examine the element of Motorists’ conduct. Because the facts of this ease are extremely important in reaching our result, we will set them forth in some detail. As noted, Appellant and Motorists began their business relationship in 1989. The two generally contracted for a six-month period of coverage, payable in two installments, one at the beginning of coverage and one three months later. From the beginning of the relationship until the February 22,1991, auto accident, Motorists twice allowed Appellant to tender late installment payments and nonetheless continue her insurance coverage. In September of 1989, Motorists accepted Appellant’s second installment over a month after the due date. After receiving the payment, Motorists issued Appellant an endorsement making the policy effective from the date the premium had been due; in other words, the late payment operated retroactively to keep the existing policy in force. In April of 1990, Appellant again sent in the second installment of her premium over a week after the due date, and again Motorists accepted the payment and applied it retroactively, continuing her coverage from the payment’s due date.

Motorists points out that, in the instant situation, Appellant did not merely miss an installment payment and instead had let her auto insurance lapse. Even when Appellant allowed her policy to lapse completely, however, Motorists continued to accept her premium payments and issue retroactive insurance coverage. For instance, Appellant’s policy lapsed in December of 1989.

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Howard v. Motorists Mutual Insurance
955 S.W.2d 525 (Kentucky Supreme Court, 1997)

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Bluebook (online)
955 S.W.2d 525, 1997 Ky. LEXIS 73, 1997 WL 336304, Counsel Stack Legal Research, https://law.counselstack.com/opinion/howard-v-motorists-mutual-insurance-ky-1997.